Medical Nonfiction for Lay Readers

There was a time I didn’t want to read one word about bodies or medicine, but maybe because of developing chronic health issues myself, or again living in the US uninsured, but as I mentioned in my first Nonfiction November post, I’ve been drawn to medical-related nonfiction lately.

Here are three targeted at lay readers that are educations in and of themselves.

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I’m not sure how much of Bill Bryson‘s The Body: A Guide for Occupants (October 2019, Doubleday) would be revelatory to anyone in the medical profession, but to a lay reader this was easily one of the most fascinatingly informative books I’ve read in recent memory. Bryson’s general appeal is somewhat mysterious to me; I’ve found his other books to be too much folksy, aw-shucks dad-joke humor. So I was pleasantly surprised at how different the tone was here. 

He uses some wry humor but it never felt forced, and the writing was completely accessible considering how much information he packs in. It’s information that stays with you; I think I’ve been quoting factoids from it constantly. (A favorite: we have some kind of internal timekeeper, it’s why you often wake up right before your alarm. But we don’t know what it is or how it works!)

Bryson moves through systems of the body, highlighting juicy bits of history and how they apply to our current understanding. Even things I already basically knew, like that Austrian medical instructor Ignaz Semmelweis was first to recognize the importance of hand hygiene, were expanded here beautifully. I didn’t know, however, that in 1847 no one wanted to hear it, and before revolutionizing medicine he lost his job and his mind, was institutionalized and murdered by asylum guards.

Perhaps my biggest takeaway: we know so little about the human body. Shockingly little. Even the most basic — like we’re not entirely sure why we need to sleep, as critical as that process is. We don’t know why sinuses are often problematic, or why they take up so much space in our heads. However bad you thought sitting for long periods was, it’s worse. Coffee doesn’t actually dehydrate you. Your liver doesn’t know the difference between sugar from fruit or from soda. Just a few of my revelations here.

In addition to the many dead-ends in medicine, the other big factor was Bryson’s constant wonder at incredible our bodies are. That’s a message I feel like we’ve been getting since seventh grade health class videos, but this drove it home powerfully. Consider his interview of a researcher working on “a system that keeps the hemoglobin inside a polymer shell.”

“At the time I met him, he believed they were three years away from trials in humans, and perhaps ten years from using it clinically.

In the meantime, it remains a slightly humbling reflection that about a million times per second our bodies do something that all the science of the world put together so far cannot do at all.”

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James Hamblin is an MD who turned to journalism, and writes accessibly for general readers about health topics at The Atlantic. He reminds me of a “science translator,” breaking down complex information for readers without medical backgrounds.

This is something Ben Goldacre has encouraged medical professionals to do, because as Hamblin notes we have so much information google-able at our fingertips that it’s hard to know what to make of it all. Science is dense for non-scientists, which is probably why people tend to listen to Gwyneth Paltrow instead.

Hamblin isn’t trying to sell anything, which is an important distinction to make between his books and certain others written by doctors, I feel. Rather, he explains concepts that are easily misconstrued. In that, If Our Bodies Could Talk is crucial for making medical information understandable for the average reader.

The tone is chatty, sometimes very funny — when explaining that blue-eyed women were once burned as witches (!) he notes that of course we now recognize witches can have any color eyes. He comes across as personable and having loved Clean: The New Science of Skin, I want to read everything he writes.

Hamblin uses the categories “Appearing,” “Perceiving,” “Eating,” “Drinking,” “Relating,” and “Enduring” to answer commonly asked questions or address misperceptions around how the body works. Some are silly, like whether a lost contact lens can end up in your brain. Plenty I’d learned from reading The Body first — namely, the supplement industry is an unregulated disaster, the science around melatonin is hazy and hasn’t been studied long-term, and misunderstandings around antibiotics from Biography of Resistance.

But he chooses some fascinating topics, particularly to explain ethical issues, like advertising by hospitals, which is a weird concept to consider. He uses the example of NYU Langone and increasing labia surgery. Langone spent $22 million on advertising in 2014, “leading the country in a surge of direct-to-consumer advertising by major medical centers. The practice, once taboo in the profession, a sign of quackery, is now commonplace and rapidly increasing.” As a journalist, he emphasizes that that advertising money targets him too, citing a press release from a publicist hired by NYU “to spread the word about labiaplasties” with the goal of at least “plant[ing] a seed in the public mind.” I was speechless.

Later, writing about an expensive heart procedure that may not even be necessary, he writes that “the most expensive health care system in the world (the United States’) …has every financial incentive to keep us alive, but little or no financial incentive to keep us well.”

He does go on a few tangents on subjects that surprised me for their intensity and felt less informative or generally relevant. But sometimes the segues were incredible, like a story about Mr. Rogers and a little girl getting an unusual brain operation (courtesy of Ben Carson) that had me ugly crying as I read it. (Side note: is there anyone on earth as wonderful as Mr. Rogers? I want to read The Good Neighbor but I’m afraid it’ll be endless ugly crying.)

In an anecdote about oral syphilis being confused with oral thrush (fun!) he mentions that the patient “went on the still popular ‘anti-candida diet,’ which is one of the seductive disease-fighting diets peddled by the Internet at large, despite thorough scientific de-pantsing over the years…It’s like nutritional chemotherapy, pushing a person to the limits of hunger and joylessness, until the fungus dies but the person does not.”

Having been on this diet of joylessness myself with zero effect, it was nice to be able to laugh about it a bit. To keep from crying at the memory. But bad treatments for women’s health brings me to Maya Dusenbery‘s Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick.

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This book is, ultimately, about how gender bias affects the care patients receive.

Dusenbery is interviewed in Clean, and having been through it with doctors misdiagnosing, mistreating, or just not giving a fuck about my illnesses for the last decade-plus, I couldn’t read this fast enough.

It’s a bit denser, data-heavy, and less chattily readable than the previous two but worth the concentration. 

Dusenbery identifies a knowledge gap – quite simply, the “average doctor does not know as much about women’s bodies and the health problems that afflict them.” This begins with using male cells and male animals in preclinical studies and doesn’t improve from there.

The second factor is the trust gap: “women’s accounts of their symptoms are too often not believed,” hearkening to the old-timey “catchall diagnostic category of hysteria.”

It’s a lot of bad news, honestly. I knew this whole situation was bad, from my own experience and that of other women, but it’s worse. Dusenbery incorporates a host of interviews with women with health problems ranging from gender-specific ones to plenty that shouldn’t have any basis for misunderstanding or misdiagnosis due to sex, and yet. She also includes the amplification of difficulties around trans health issues, and the biases here were eye-opening and shocking.

“The medical community has viewed women’s health with a bikini approach, focusing essentially on the breast and reproductive system,” according to Dr. Nanette Wenger, a leading expert on women’s heart disease. Baffling to consider that even heart disease, the leading cause of death in the US and something at which we’ve thrown endless research time and dollars, encounters misdiagnoses and errors in women because they’re women.

Part of it is that “women’s symptoms are ‘all in their heads’ — until proven otherwise. This assumption has had incredibly long-lasting effects on what is known about women’s health and diseases and how women are treated when they enter the medical system.”

Doctors don’t get feedback about misdiagnoses because patients aren’t likely to return to someone who didn’t listen, dismissed them, or made them feel humiliated and accused of fabricating or exaggerating. Instead, they go to more doctors, for years on average, until finding one who makes the correct diagnosis. This is especially prevalent in women with autoimmune disease. “Once doctors have settled on one answer, they stop looking for another. But, in the worst-case scenario, the patient stops looking too.” Or she runs out of money for looking. Dusenbery reports one woman spent $400,000, went to 210 doctors including the Mayo Clinic, and only ever got a diagnosis of mental illness. She had ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome).

“There is no class of diseases that don’t usually kill you but can ruin your quality of life that is just as prevalent and is twice as common among men.” This was something that came up in The Lady’s Handbook for Her Mysterious Illness and I’ve been turning in my mind since. My own illnesses won’t kill me, they’re not cancer-related or life-threatening. And yet they’ve changed my quality of life — even the course of my life — completely. Sarah Ramey quotes a statistic in that book about chronic illness sufferers consistently reporting lower quality of life than cancer patients. It’s not to diminish cancer, but to emphasize what it feels like to be shrugged off and still symptomatic with no end in sight.

Chronic illness, with its invisible symptoms of fatigue and pain, is largely the burden of women. And it’s worth considering to what extent its relative neglect by the medical system is because it mostly affects women, whose complaints are so often heard not as a roar but a whine.

Pain is real when you get other people to believe in it.

When an orthopedic surgeon was diagnosed with interstitial cystitis herself, formed the Interstitial Cystitis Association and discussed it on Good Morning America, she received donations from family members of IC sufferers who had committed suicide “to end the agony.” It underscores that these problems aren’t only frustrating, time-consuming, and expensive, they’re devastating and sometimes beyond our coping capacities.

The biggest problem is that there are so many problems. You can’t win for losing if you’re a sick woman, basically. Whatever your demographic and condition, doctors have a stereotype to fit you:

Women’s ‘doctor stories’ are similar, even when they are quite different. A white Ivy League college student is more likely to be seen as anxiety-ridden, while a woman of color is more likely to be stereotyped as a drug seeker. “Educated white women” are seen as health-obsessed hypochondriacs who need to get off WebMD. But less-educated women may be seen as malingerers looking for a disability check. A thin woman is told she can’t be seriously ill since she ‘looks so good!’ while a fat woman is told all her symptoms are due to her weight. For most of our lives, we are “too young” to be sick anyway, and our symptoms can be blamed on menstrual cramps, pregnancy, motherhood, and menopause. By the time we’re finally old enough to be seen as sick, we’re so old that nobody cares if we are.

As a step towards solutions, she emphasizes the importance of women’s advocacy, becoming a “more well-informed, educated health care consumer” and doing research yourself, even while acknowledging how fucked up it is that we’re “asking individual women to compensate for the medical system’s failures.”

It armed me with a lot of helpful information, as well as a feeling of support and solidarity often missing when grappling with health woes and feeling alone in your own personal medical horror story. Every woman and every medical professional should read it. (March 6, 2018 by HarperOne)

Any medical nonfiction for lay readers you can recommend?

35 thoughts on “Medical Nonfiction for Lay Readers

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  1. These all sound excellent and important. So much work to be done! It’s disheartening that there is such a gender bias in women’s health, but at least it’s getting called out more now. And the line about the US health system having a great incentive to keep us alive, but none at all to keep us well, is so true.

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    1. I agree, so much work to be done! It feels like a long way to go but I feel more optimistic that there’s at least more information readily available and more recognition of what’s been going on. I hope we’re on a path to improvement. And isn’t that a horrifying thing to consider, that it’s so profit-driven? I was also so shocked at his writing about hospitals trying to increase their profits with needless surgeries. I just don’t even know what to say.

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  2. I’m one of those readers who’s never felt a lot of appeal for reading about medicine and the body, but all of these look like very digestible and informative sources that would fit my level of knowledge (or lack thereof)- I appreciate the round-up. Doing Harm in particular sounds like a must-read!

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    1. Doing Harm is such a must-read. It was eye opening and enraging but very necessary. And all of these are surprisingly enjoyable reads even if you’re not that drawn to the subject matter, which was always the case for me too. They really appeal to natural curiosity!

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  3. I’ve never picked up a non-fiction book on medicine as a pastime (I have enough reading for work and continuing ed!) but Doing Harm sounds important! Similar problems of not believing people/providers not investigating thoroughly enough are true for people of color, as well, which is why one subject which I have been independently trying to find out more lately is racial justice in healthcare.

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    1. I know what you mean, these really weren’t the kind of books that would be my go-to reads, but I promise all of them are so worthwhile! Doing Harm includes a look at issues of racial basis in women’s healthcare as well. Do you know Tressie McMillan Cottom? She has an excellent (and harrowing) essay in her collection Thick about her experience as a Black woman during her pregnancy. I really recommend it if you haven’t come across it already. There’s some elements of racial justice in healthcare addressed in Michele Harper’s memoir of being an ER physician, The Beauty in Breaking, as well.

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  4. I haven’t read any of these so far – though I do have The Body on my shelf, as my brother gave it to me last year for Christmas. I loved Bryson’s writing when I was younger and read him a lot in my teens, but his schtick lost its appeal for me in recent years, so I’m pleased to hear that the tone is different for this one! I still love Notes from a Small Island, which I think really gets to a lot of what makes the UK so weird, but his other stuff doesn’t work for me any more.

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    1. “Shtick” is exactly it, that’s what his writing felt like to me in everything I’ve read besides this one. It just gets old very quickly. The Body is entirely different though, I promise. You recognize a bit of the wry humor as being his but otherwise it felt like a totally different author to me. That’s good to know about Notes from a Small Island though, I haven’t read that one and don’t have a ton of knowledge about the UK, so seems like that might be an interesting read!

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      1. It does come with the caveat that I haven’t read it in about a decade – so I might not still agree with past me – but I think that Brits voted it “best book about the UK” in some poll or other years ago, so there’s a broad consensus that it’s reasonably accurate!

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      2. I know what you mean, I hesitate sometimes recommending things I read so long ago when I think my opinions might have changed! That’s really interesting that there was such a broad consensus around it in the country though. I wonder if other countries would be so enthusiastic about books about their quirks by outsiders! (I feel like Americans would be so offended). I’m definitely intrigued by that. I’ll give him a chance again for that one 🙂

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  5. Wonderful reviews, I think, I will read The Body at some point. Also, I love the small useful facts you managed to incorporate in the reviews, such as coffee not being dehydrating (really??!) and more importantly, witches having different eye colours 😉

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    1. Thank you so much! The Body is such a great read, and not nearly as heavy or intense as you might expect. It’s so readable, and dare I say really fun. Isn’t that crazy about the coffee? I told that fact to a friend currently in med school and she barely believed me. But it makes you pee a lot because it’s so much water, not because it’s dehydrating you. It actually counts towards how much water you should drink in a day. And it makes sense, when I lived in Europe and espresso was more common than my preferred drip coffee, it never affected me the way my typical morning 6-cup pot does 😂 It’s such a treasure trove of interesting information!

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  6. Three good reviews, thank you for sharing these. I’m trying to steer clear of reading about medical stuff in case I think I have ALL THE THINGS as our hospitals locally have just paused all non-emergency operations for the foreseeable future! But it’s important to have books like these out there.

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    1. Oh I completely know what you mean. I think that’s a normal reaction to medical topics, I’ve read even med students have that happen when learning about certain diseases and the like in school 🙂 So we’re normal!

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  7. I usually stay away from medical books and medical TV dramas. Perhaps the fear is that they will get too technical or too gory — or the reverse, too inaccurate! So, thanks for the suggestions! And I wonder if you’ve tried Leslie Jamison’s Empathy Exams? Had heard a lot of praise about it some time back, though I never got to read it myself.

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    1. Yes, that’s a good point! Actually one of the books, If Our Bodies Could Talk, points out exactly that problem, that we think resuscitation/chest compressions are much more able to save lives thanks to shows like ER and Grey’s Anatomy. Isn’t that crazy? I’ve never even watched those shows and yet that idea has definitely permeated mainstream thinking.

      I haven’t read the Empathy Exams but I’ve heard of it, and some other bloggers I trust really love it! I need to give it a try, I think.

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  8. Fantastic review of some really fascinating books. An anecdote on medical bias against females. One of my sisters nearly died as a baby because she had a condition that ‘only boys get’. Thanks to my mother being a nurse, she saved my sisters life and there was less trouble getting an operation for my other sister who also had the same condition.

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    1. Oh my gosh, how unbelievably awful. Your mother must have been terrified but thank goodness she could recognize what was going on. That’s exactly the problem though, we’re trained to defer to medical opinion and of course it’s too much to be able to educate ourselves on everything, but it ends up putting us and our health at the mercy of their biases. The gender issues are outrageous. Some of the women interviewed in the book only got help when they took men with them to their appointments to verify their symptoms/suffering. None of this should be happening.

      I’m so glad your sisters came through their issues safely thanks to your mom!

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      1. It is shocking that this happens. My sisters were lucky because my mom had medical knowledge, but lots of people don’t have that benefit. My sisters would have died if my mom hadn’t known what to do.
        I hope doctors read books like this and remember to treat each patient as an individual rather than a demographic.

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  9. I’m really interested to hear that you liked The Body even though you don’t usually like Bill Bryson, because I wasn’t impressed with A Short History of Nearly Everything (all info I knew, less entertaining than Mary Roach) and have avoided his books ever since. I’ve been seeing great review of The Body though and have been tempted by the topic. I’ll consider giving Bryson another try 🙂

    I also enjoyed Hamblin’s humorous approach and I’m glad it worked for you too. Still looking forward to Clean!

    The last book on your list sounds well worth the read. I’m sorry that it’s been so personally relevant in your life. That quote showing how any woman can be stereotyped and dismissed was incredibly discouraging.

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  10. Great reviews, these sound excellent. I have persuaded my local library to buy Skin (on basis we all have skin, although possibly library run by alien scale-y lizard people???) I have Ben Goldacre’s Big Pharma on my to read shelf.

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    1. Ooh what is Skin?? And yes, according to David Icke we have the Reptilians all around us. Who can know. Although they don’t seem to exert as much world-dominating control from the library, I guess much as the librarians might feel they do? (We’ve got a really mean one in my neighborhood library that’s open for pickups at the moment, she’s scaring me!)

      I loved Goldacre’s Bad Science but had to give up on Bad Pharma. I picked out a few interesting points but I really had trouble following much of it, it was going over my head 😞 I was so disappointed by that because Bad Science was such a favorite. You’ll have to let me know what you think when you read it.

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      1. Oh so sorry I meant Clean, not Skin! Got muddled! Will be sad if Bad Pharma a let down. Funny you mention David Icke. Did you see he has re-emerged recently in London protests against lockdown and masks and vaccine etc?

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      2. Oh I hope you like Clean, I thought it was SO good. Really changed my thinking about a lot of things. I don’t think Bad Pharma is a letdown, two of the people who recommended Bad Science to me both loved it. It just went over my head, maybe I needed to concentrate on it better or it wasn’t a good starting point without any background knowledge. I would definitely give it another try at some point.

        Ugh I hadn’t seen that but doesn’t surprise me, he’s an utter kook! Any of this protesting just blows my mind at the ridiculosity and nonsensicalness of it so of course he would be involved. I wonder if Fauci is a Reptilian. Like how does David Icke even know? He’s so specific sometimes about who is and who isn’t.

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